Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

WATER FOR IRRIGATION 200ML

Facility

$82.01

Service Code	NDC 409797307
Hospital Charge Code	606361018
Hospital Revenue Code	272
Min. Negotiated Rate	$2.33
Max. Negotiated Rate	$41.01
Rate for Payer: Aetna Commercial	$31.16
Rate for Payer: Aetna Medicare Advantage	$24.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.91
Rate for Payer: Cigna Commercial	$41.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.32
Rate for Payer: Oxford Commercial	$16.40
Rate for Payer: Qualcare PPO/HMO/WC	$12.30
Rate for Payer: UnitedHealthcare Commercial	$16.40
Rate for Payer: UnitedHealthcare Community & State	$2.59
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

WATER IRRIGATION STER 1000ML

Facility

$22.50

Hospital Charge Code	270040020
Hospital Revenue Code	270
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

WATER IRRIGATION STER 1000ML

Facility

$22.50

Hospital Charge Code	270040020
Hospital Revenue Code	270
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.85
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.50
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

WATER IRRIGATION STER 2000ML

Facility

$22.50

Hospital Charge Code	270040030
Hospital Revenue Code	272
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.85
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.50
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

WATER IRRIGATION STER 2000ML

Facility

$22.50

Hospital Charge Code	270040030
Hospital Revenue Code	272
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

WATER IRRIGATION STER 500ML

Facility

$22.50

Hospital Charge Code	270040025
Hospital Revenue Code	272
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

WATER IRRIGATION STER 500ML

Facility

$22.50

Hospital Charge Code	270040025
Hospital Revenue Code	272
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.85
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.50
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

WATER IRRIG STER 1000ml

Facility

$17.70

Hospital Charge Code	270653165
Hospital Revenue Code	272
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$8.85
Rate for Payer: Aetna Commercial	$6.73
Rate for Payer: Aetna Medicare Advantage	$5.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.51
Rate for Payer: Cigna Commercial	$8.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.60
Rate for Payer: Oxford Commercial	$3.54
Rate for Payer: Qualcare PPO/HMO/WC	$2.65
Rate for Payer: UnitedHealthcare Commercial	$3.54
Rate for Payer: UnitedHealthcare Community & State	$0.56
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

WATER IRRIG STER 1000ml

Facility

$17.70

Hospital Charge Code	270653165
Hospital Revenue Code	272
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$2.65
Rate for Payer: Qualcare PPO/HMO/WC	$2.65

WATER IRRIG STER 3000ml

Facility

$47.70

Hospital Charge Code	270649261
Hospital Revenue Code	272
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$23.85
Rate for Payer: Aetna Commercial	$18.13
Rate for Payer: Aetna Medicare Advantage	$14.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.16
Rate for Payer: Cigna Commercial	$23.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.40
Rate for Payer: Oxford Commercial	$9.54
Rate for Payer: Qualcare PPO/HMO/WC	$7.16
Rate for Payer: UnitedHealthcare Commercial	$9.54
Rate for Payer: UnitedHealthcare Community & State	$1.51
Rate for Payer: Wellpoint Medicaid Managed Care	$1.35

WATER IRRIG STER 3000ml

Facility

$47.70

Hospital Charge Code	270649261
Hospital Revenue Code	272
Min. Negotiated Rate	$7.16
Max. Negotiated Rate	$7.16
Rate for Payer: Qualcare PPO/HMO/WC	$7.16

WATER IRRIG STER 500ml 6139-03

Facility

$22.50

Hospital Charge Code	270649263
Hospital Revenue Code	270
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

WATER IRRIG STER 500ml 6139-03

Facility

$22.50

Hospital Charge Code	270649263
Hospital Revenue Code	270
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.85
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.50
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

WATER PETROLAT MINRL OIL 120GM

Facility

$34.37

Service Code	NDC 54162060002
Hospital Charge Code	60628463
Hospital Revenue Code	250
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$17.18
Rate for Payer: Aetna Commercial	$13.06
Rate for Payer: Aetna Medicare Advantage	$10.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.76
Rate for Payer: Cigna Commercial	$17.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.94
Rate for Payer: Oxford Commercial	$6.87
Rate for Payer: Qualcare PPO/HMO/WC	$5.16
Rate for Payer: UnitedHealthcare Commercial	$6.87
Rate for Payer: UnitedHealthcare Community & State	$1.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.98

WATER PETROLAT MINRL OIL 120GM

Facility

$34.37

Service Code	NDC 54162060002
Hospital Charge Code	60628463
Hospital Revenue Code	250
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$5.16
Rate for Payer: Qualcare PPO/HMO/WC	$5.16

WATER STERIL 1000cc BOTTLE

Facility

$22.50

Hospital Charge Code	270650061
Hospital Revenue Code	272
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

WATER STERIL 1000cc BOTTLE

Facility

$22.50

Hospital Charge Code	270650061
Hospital Revenue Code	272
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.85
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.50
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

WATER STERILE 1000cc BAG

Facility

$17.70

Hospital Charge Code	270650118
Hospital Revenue Code	270
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$8.85
Rate for Payer: Aetna Commercial	$6.73
Rate for Payer: Aetna Medicare Advantage	$5.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.51
Rate for Payer: Cigna Commercial	$8.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.60
Rate for Payer: Oxford Commercial	$3.54
Rate for Payer: Qualcare PPO/HMO/WC	$2.65
Rate for Payer: UnitedHealthcare Commercial	$3.54
Rate for Payer: UnitedHealthcare Community & State	$0.56
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

WATER STERILE 1000cc BAG

Facility

$17.70

Hospital Charge Code	270650118
Hospital Revenue Code	270
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$2.65
Rate for Payer: Qualcare PPO/HMO/WC	$2.65

WATER, STERILE 10ML 10 ML SOL

Facility

$22.65

Service Code	NDC 63323018510
Hospital Charge Code	6063943271
Hospital Revenue Code	250
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$11.32
Rate for Payer: Aetna Commercial	$8.61
Rate for Payer: Aetna Medicare Advantage	$6.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.78
Rate for Payer: Cigna Commercial	$11.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.89
Rate for Payer: Oxford Commercial	$4.53
Rate for Payer: Qualcare PPO/HMO/WC	$3.40
Rate for Payer: UnitedHealthcare Commercial	$4.53
Rate for Payer: UnitedHealthcare Community & State	$0.72
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

WATER, STERILE 10ML 10 ML SOL

Facility

$22.65

Service Code	NDC 63323018510
Hospital Charge Code	6063943271
Hospital Revenue Code	250
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$3.40
Rate for Payer: Qualcare PPO/HMO/WC	$3.40

WATER STERILE 250cc BOTTLE

Facility

$22.50

Hospital Charge Code	270650064
Hospital Revenue Code	272
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

WATER STERILE 250cc BOTTLE

Facility

$22.50

Hospital Charge Code	270650064
Hospital Revenue Code	272
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.85
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.50
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

WATER STERILE 2OUNCE BOTTLE

Facility

$22.19

Hospital Charge Code	270653903
Hospital Revenue Code	272
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$11.10
Rate for Payer: Aetna Commercial	$8.43
Rate for Payer: Aetna Medicare Advantage	$6.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.66
Rate for Payer: Cigna Commercial	$11.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.77
Rate for Payer: Oxford Commercial	$4.44
Rate for Payer: Qualcare PPO/HMO/WC	$3.33
Rate for Payer: UnitedHealthcare Commercial	$4.44
Rate for Payer: UnitedHealthcare Community & State	$0.70
Rate for Payer: Wellpoint Medicaid Managed Care	$0.63

WATER STERILE 2OUNCE BOTTLE

Facility

$22.19

Hospital Charge Code	270653903
Hospital Revenue Code	272
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$3.33
Rate for Payer: Qualcare PPO/HMO/WC	$3.33

Know your out-of-pocket cost for care.

All Charges